Electrocautery Dissection and Blunt Dissection for Breast Implants

What percentage of doctors use electocautery dissection and blunt dissection for breast implants? How much is the pain reduced using electrocautery dissection?

Doctor Answers 12

Another vote for cautery rather than blunt dissection for breast augmentation

Blunt dissection, by definition, involves ripping the tissues apart blindly while cautery dissection is done under direct vision with precision. Since it also controls bleeding there is less bruising. All of this means faster recovery with less discomfort, though I remain skeptical about the "24 hour return to normal activities" that some claim.

Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

HUGE Reduction in Breast Augmentation Pain by avoiding Blunt Dissection.

I TOTALLY agree with Dr. Rand. The prime standard bearer for precise pocket dissection with cautery rather than blunt dissection has been Dr. John Tebbetts of Dallas who suffered the scorn of many of our colleagues for his opinions. Myself and many other Plastic surgeons think very highly of him. Those who abandoned blunt dissection and adopted his techniques have greatly improved the quality of our results and our patients' satisfaction.

Aside from increased speed (resulting in bleeding and possibly a higher rate of capsular contracture) there is no advantage to the patient from blunt pocket dissection of the breast implant pockets.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Electrocautery dissection reduces trauma and pain

Blunt dissection involves using the finger to sweep around and open up the pocket where the implant is to be placed. Electrocautery dissection is more precise, involving cauterization of the blood vessels in the area to reduce trauma and potential for blood loss. Referred to as bloodless breast augmentation, it also leads to faster recovery times.  

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Dissection techniques

The most important thing about the dissection is to remain as bloodless as possible with whichever technique you use.  I think electrocautery works best.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Augmentation Technique

There have been a number of studies about the complication rates and speed of recovery relating to peri-operative factors in breast augmentation. Complication and reoperation rates have significantly fallen with careful discussion of patient desires, use of patient centered measurements in choosing an implant and careful surgical technique, including the method of dissection of the pocket. By doing these things, reoperation rates are about 2%, not the reported 15-20% seen in most studies. Recovery has also been reduced to 24-36 hours, partly depending on where one places the implant.

One of the most important factors believed to be responsible for a quick recovery is careful dissection of the pocket with knife or electrocautery rather than blunt dissection. There are no surveys that I am aware of that have asked how many surgeons use each method. It is my impression, however, that the majority of surgeons use blunt dissection rather than electrocautery. Most ladies I talk to that have had an augmentation mention a week before recovery. Most of my patients on whom I have used electrocautery dissection and minimal retraction are back to normal activities by the next day.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Electrocautery dissection and blunt dissection for Breast Implants

Great technique question, more like a first year plastic surgery resident type question. As seen in these previous postings the electro cautery dissection is far above any blunt finger or instrument dissection. The recovery, degree of swelling, amount of black and blue (ecchymosis), potential hematoma are much less with the cautery. When we see post augmentation patient I almost can guess the surgeon if from my area who uses blunt dissection. Thanks for a great question.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Electrocautery versus blunt dissection for breast augmentation with implants

This varies tremendously with each surgeon and with each approach. For example probably 90% of TUBA procedures are done primarily with blunt dissection. Whereas the breast crease approach can be accomplished via a variety of techniques. Electrocautery can also be delivered using bipolar forceps which is a more direct and locatlized application of the energy.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Blunt vs. Cautery Dissection for Breast Augmentation

Hi there-

I also feel strongly that precise cautery dissection has lowered my complication rates and simplified recovery for my patients. I do not think that the procedure takes any longer either.

This is a no brainer.

As for your question about how many surgeons do which, I could not say, but I think time will strengthen the knowledge base and more surgeons will use cautery only technique.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Cautery vs blunt dissection


rate and careful dissection that is used in breast surgery, there is a decreased incidence of pain, swelling and post-op bleeding. This is one reason I am not a fan of TUBA surgery.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

Both work and pain is an individual issue

I use both blunt, sharp and electrocautery dissection. I don't find it makes a difference in patient pain. What works for me is the use of a long term anesthetic placed in the pocket prior to inserting the implant. My patients have very few complaints of pain.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.